Role of Today’s Healthcare Workforce

A briefing held on November 9th by the Alliance for Health Policy  examined many of the factors affecting today’s healthcare workforce both negatively and positively. The various keynotes and panel discussions examined the possible solutions needed to meet the needs of patients and physicians in today’s healthcare environment.

According to Keynoter Polly Pittman, Professor of Health Policy and Management at the Milken Institute School of Public Health, George Washington University and as Co-Director at the GW Health Workforce Institute said, “Evolving roles and tasks are rapidly shifting for physicians with the allied medical staff growing more than the basic medical staff.”

She added, “In addition, there has been a dramatic increase in behavioral health playing a bigger role in providing healthcare. For example, when dealing with home care and long-term care, nurse practitioners are making home visits for Medicare patients as it is too expensive to send physicians.”

Another big change affecting medical care is related to the opioid crisis. The ECHO Institute at the University of New Mexico’s Health Sciences Center is in the forefront of using technology to combat opioid addiction.

Keynoter Miriam Komaromy, Associate Professor of Medicine and Associate Director of the ECHO Institute, pointed out that the Institute is activity expanding opioid treatment through their “National Opioid ECHO Program.

ECHO has developed five Opioid ECHO Shared Service Model hubs called “Hub-lets”. The “Hub-lets” enable the development of the IT curriculum, enables IT evaluations, administers the program, and recruits participants for all the hubs.

So far, this Opioid ECHO program is being used not only at the University of New Mexico, but also at the Opioid ECHO Model in Western New York, at the Boston Medical Center, University of Washington, and at a clinic in Billings Montana.

A panel discussion moderated by Sarah Dash, President and CEO of the Alliance for Health Policy, described the trends that are elevating the importance of the behavioral health workforce. Panelists also discussed what steps can be taken to recruit and retain the behavioral health workforce to work with other healthcare professionals.

Peter Maramaldi, Professor and Director of the PhD Program at the Simmons School of Social Work reports, “Including social workers in medical care can produce behavioral changes. However, to move forward, physicians have to stop doing so many secondary tasks and use someone else trained to complete the task.”

According to Andrew Sperling, Director of Federal legislative Advocacy for the National Alliance on Mental Illness (NAMI), “Primary care physicians need to inform the behavioral health workforce when mental health issues are noted in patients especially if the patient is dealing with depression.

“Integration is the name of the game. It is now time for the behavioral health workforce to converge with physical healthcare,” reports Mohini Venkatesh, who leads the National Council for Behavioral Health’s efforts to support partnerships involved in community behavioral health.

In news related to the behavioral health field to help Medicaid and CHIP beneficiaries, Medicaid has established a demonstration project in eight states that includes Minnesota, Missouri, New York, New Jersey, Nevada, Oklahoma, Oregon and Pennsylvania.

These states will participate in a two year demonstration program that will pay certified community behavioral health clinics under a prospective payment system to provide evidence-based behavioral health services.

A second panel discussion moderated by Julie Rovner, Chief Washington Correspondent at Kaiser Health News, focused on how the delivery system reform has created both challenges and opportunities for the healthcare workforce. Discussion centered on how delivery system reform has affected care coordination, new health professions, and what is required in terms of education and training.

Panelist Thomas Jenike MD, Family Physician and Senior VP and Chief Human Experience Officer for Novant Health, described how he and other physicians are experiencing physician burnout due to all the rapid changes taking place. He noted that burnout in general is a grave threat to the organization.

Ann Greiner, President and CEO of the Patient-Centered Primary Care Collaborative added, “Physicians today are spending less time with patients plus the fact that using technology while it can be very effective, can also affect physicians in a negative way.”

Panelist Robert McNellis, Senior Advisor for Primary Care in the Center for Evidence and Practice Improvement at the Agency for Health Research and Quality (AHRQ),  explains, “The changes taking place and the training needed to use technology has created some problems, but in general, technology has made medical offices work more efficiently and improved the teamwork needed to effectively care for patients in today’s world”.

The third panel of the day, concentrated on caring for an aging population and the need to address how stress, low salaries, and limited employee benefits are affecting the workforce in providing care to the elderly.

The panel moderated by Marcus Escobedo, Senior Program Officer at the John A. Harford Foundation Panelists included Thomas Edes, Director of Geriatrics and Extended Care for Clinical Operations for the VA, Clare Luz PhD, in Family Medicine at Michigan State University , and Joanne Lynn, MD, Director of the Center for Elder Care and Advanced Illness at the Altarum Institute

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